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Naturopathic doctors are covered by most major insurance plans in Oregon. You can contact your health insurance provider to find out the details of your naturopathic coverage.

The Affordable Care Act prohibits insurance plans from discriminating against providers in either participation or coverage in a plan. This provision applies to all non-grandfathered commercial plans issued or renewed after January 1, 2014.

Oregon law that governs Coordinated Care Organizations (CCOs) also contains provider non-discrimination language identical to that of the federal ACA. Consequently Oregon CCOs are also prohibited from discriminating against providers in both participation and coverage in CCOs. This provision applies to all Oregon Health Plan Medicaid patients.

The ACA launched many new initiatives and many insurers are struggling either to come into compliance with the details of the law or have come into compliance but are struggling to update their materials or adequately train their customer service staff on their new policies.

Below is a list of insurance companies that credential NDs as either a Primary Care Provider or Specialist. This list is not intended to be a comprehensive list of problems with insurers. If an insurer and/or their policy is listed here, it is because an ND has successfully been credentialed, or because OANP has directly received confirmation from the insurer of their policy on insurance coverage for NDs. Please be aware that individual customer service representatives MAY NOT be aware of these policies. If you get information that is contradictory to what is listed here, please ask for a supervisor and reference this information. We will list the source of information where we can so you can speak directly with someone knowledgeable in the companies. Please also inform OANP immediately if you find anything wrong or missing, or if you have new information to add.

Coordinated Care Organizations

CCO

Location

Notes

Contact

HealthShare Oregon (through CareOregon)

PDX Metro

NDs can be PCP

(503) 416-4100

FamilyCare

PDX Metro

NDs can be credentialed only if share office with MD/DO

Yamhill CCO (through CareOregon)

Yamhill County

NDs can be PCP

(503) 416-4100

Columbia Pacific CCO (through CareOregon)

N. Coast

NDs can be PCP

(503) 416-4100

Western Oregon Advanced Health

Coos Bay/Bandon

NDs can be Specialist. May be open to PCP dependent on certain criteria being met.

Any provider providing a service covered by an insurance plan is eligible for reimbursement based on the member's benefits. Simply put, if you do a service that is covered by the plan, Regence will cover it when done by an ND too. Read their bulletin here.

United

Statewide

If using the same CPT codes as a medical doctor, United will cover NDs if they are in network and as a specialist. The specialist co-pay will apply.

Providence

Statewide

Will cover naturopathic doctors as a specialist unless the ND has had a 1 year residency, then may be covered as a PCP.